Our Practice Policies

Welcome! We appreciate this opportunity to serve you. This page contains information about our practice and is provided to answer most of the questions you might have about us. If you do not find answers to your questions, we welcome you to use our CONTACT FORM or call us at (817) 431-2573.


Practice Hours

Monday – Thursday 8:00 to 6:00

Friday 9:00 to 5:00

Office is closed each day from 12:00 to 1:30



Patients are seen by appointment. When scheduling an appointment, please give the receptionist as much information as possible to ensure you are scheduled in an appropriate appointment time. If you arrive 15 minutes after your scheduled appointment time, you may be asked to reschedule depending on the provider’s schedule for that day.


Cancelation Policy

A two (2) hour notice must be provided when canceling your scheduled appointment. If a two hour notice is not received, you may be charged a $25.00 fee. This charge will be your responsibility; your insurance carrier will not be billed.


Phone Calls

Our main office number, 817-431-2573, is answered 24/7, after hour calls are forwarded to our answering service. In a life-threatening situation call 911. Phone calls answered by the office are returned after morning and afternoon patients in the office have been seen. Calls received after 4:30 will be returned the next business day.


Medication Refills

When you need a refill, please contact your local or mail order pharmacy. They will fax our office a refill request. Please allow 24 hours to process refill requests. Requests are not processed after office hours, weekends or holidays.


A refill request will be denied if you missed a scheduled appointment, are not current on any laboratory tests required for the medication, or have not had your annual physical exam. If you are stable on your medications the schedule below is followed:

  • Diabetic medications require labs drawn every 4 months and exam with provider
  • Cholesterol medications require labs drawn every 6 months and exam with provider
  • Thyroid medications require labs drawn every year at annual physical exam
  • Hypertension medications require an exam every 6 months with provider
  • An annual physical is required on every patient with a medical condition that is treated in our office


Payment Policy

We are contracted with many insurers and health plans. We will bill those plans with which we have an agreement and will collect any required co-payment, deductible or co-insurance amount at the time of service. The co-payment will be collected when you arrive for your appointment. You are responsible for ensuring that we are providers on your insurance plan and for knowing what services you have coverage for, including but not limited to office visits, labs, x-ray, procedures, physicals and immunizations. You will be responsible for paying for all services not covered by your insurance plan within thirty days of receiving a statement.

If your insurance, address or phone number should change, please notify us immediately so that we can update your chart. Please bring your insurance card to each visit.


Treatment of a Minor

A minor is any person under the age of 18 who has never been married or declared an adult by a court.

  • In order for our office to treat a minor, we must have a written consent from a parent or legal guardian, including a statement as to the nature of the medical treatment to be given on a specific day.
  • Minors age 15 and under MUST be accompanied by an adult who is 18 years of age and older, with a consent from a parent or legal guardian.
  • Minors age 16 or 17 must have written consent from a parent or legal guardian.

All minors must be accompanied by their parent or legal guardian in order to provide immunizations, invasive procedures, lab draws or injections.



Many insurance plans or specialists office require a referral from your primary care office. Please allow 3 business days for our office to process a referral. Our referral specialist will contact you when the referral has been completed so that you can then contact the specialist office for an appointment.


Motor Vehicle Accidents (MVA)/Third-Party Liability

Our office does not file charges related to an MVA or third-party liability injury with your insurance. Payment is due at the time of service; an itemized receipt will be provided that you can submit to your MVA insurance carrier or third party insurance payer.


Workers’ Compensation/DOT Physicals

We are not a Workers’ Compensation or DOT authorized provider; therefore, we cannot treat you for any work related illness or injury or perform your DOT physical. Workers’ Compensation benefits could be denied if you claim your condition is not work related but it actually is.


FMLA/Disability Forms

There is a $25 fee for completion of these forms and our office requires 7 business days to complete.


Patient Portal

We invite you to register for our patient portal, which allows electronic access to your personal health record and electronic communication with our office.


Privacy Practices

You may at any time request a copy of our privacy practices. Our privacy practices are also posted on our website at KellerFamilyMedical.com.

Practice Policies